4123-17-71
One claim program.

(1)
"One claim program" or "OCP" means the
bureau's voluntary rate program which offers a private, state fund employer
or a public employer taxing district employer the
opportunity to mitigate the impact of a significant claim that will enter the
employer's experience for the first time.

(2)
"Program eligibility period" means the
four or five policy years in which an employer
has a significant claim in its experience period.

(3)
"Significant claim" means a claim whose
total value or maximum claim value, whichever is lower, will be greater than
the employer's total limited losses (TLL) as defined in rule
4123-17-03 of the Administrative
Code.

An employer's participation in the OCP is voluntary. The
employer shall apply to participate in the OCP for each year of the program
eligibility period. The bureau shall have the final authority to approve an
eligible employer for initial and continued participation in the OCP.

(1)
An employer may withdraw from the OCP
under this rule at any time. An employer that withdraws from the OCP after
receiving a discount will return to its own individual experience rating for
that policy year.

(2)
If the employer withdraws from the OCP
and has any remaining years in the program eligibility period, the employer may
reapply for the OCP and designate the same significant claim as its one
claim.

At the time of an employer's initial application for the OCP,
the employer must be enrolled in the group experience rating program. At the
time of initial application and each renewal application, the employer shall
meet the following program requirements:

(1)
The employer must be current with respect
to all payments due the bureau, as defined in paragraph
(A)(1)(b) of rule
4123-17-14 of the Administrative
Code.

(2)
The employer must be
current on the payment schedule of any part-pay agreement into which it has
entered for payment of premiums or assessment obligations.

(3)
Except as provided for
in paragraphs (C)(3)(a) and (C)(3)(b) of this rule, the employer
must
not have cumulative lapses in workers' compensation coverage in excess of forty
days within the prior twelve months.

(a)
For the policy year commencing July 1, 2015, private
employers must not have cumulative lapses in workers' compensation coverage in
excess of forty days within the preceding nine months.

(b)
For policy year
commencing January 1, 2016, public employer taxing districts must not have
cumulative lapses in workers' compensation coverage in excess of forty days
within the preceding nine months.

(4)
The employer
must report actual payroll for the preceding policy year and pay any premium
due upon reconciliation of estimated premium and actual premium for that policy
year no later than the date set forth in rule
4123-17-14 of the Administrative
Code. An employer will be deemed to have met this requirement if the bureau
receives the payroll report and the employer pays premium associated with such
report before the expiration of any grace period established by the
administrator pursuant to paragraph (B) of rule
4123-17-16 of the Administrative
Code.

(1)
In signing the
application form, the chief executive officer or designated management
representative of the employer is certifying to the bureau that the employer
will comply with all program requirements.

(2)
An employer may have a maximum of three
medical-only claims at any time in addition to the one significant claim.

(a)
As a medical - only claim exits the
employer's experience period, the employer may include a new medical - only
claim.

(b)
The total combined costs
of these claims must be below the employer's TLL.

(3)
An employer may participate in the OCP on
no more than one significant claim within the program eligibility
period from the date of the employer's initial participation in the
program.

(4)
Once a claim has been
designated as the significant claim in initial enrollment for a program
eligibility period, an employer is not permitted to change the claim designated
as the significant claim.

(5)
Settled and subrogated claims will be included in the employer's total claim
count.

(6)
In the first year of the
program eligibility period, the employer shall participate in an
industry-specific half-day safety program prescribed by the division of safety
and hygiene. In subsequent years of the program eligibility period in which the
employer elects to participate in the OCP, the employer shall complete an
online training class prescribed by the division of safety and
hygiene.

(1)
The bureau will credit an employer
that meets all the criteria with a discount from the employer's base rate as
follows:

(a)
In the first year of the program
eligibility period, twenty per cent;

(b)
In the second year of the program
eligibility period, fifteen per cent;

(c)
In the third year of the program
eligibility period, ten per cent;

(d)
In the fourth year of the program
eligibility period, five per cent ; and

(e)
In the fifth
year of the program eligibility period, five per cent.

(2)
If an employer participating in OCP would have a
lower experience modifier (EM) under the EM cap set forth in rule
4123-17-03.2 of the
Administrative Code, the bureau shall apply the EM cap instead of the OCP
discount.

If the employer fails to meet the eligibility or general
requirements of paragraph (C) or (D) of this rule, the bureau will remove an
employer from participation in the OCP at the beginning of the next policy year
and, upon removal, will return the employer to its individual experience
modifier.

(G)
An employer
may appeal the bureau's application rejection or the bureau's participation
removal in the OCP to the bureau's adjudicating committee pursuant to section
4123.291 of the Revised Code and
rule 4123-14-06 of the Administrative
Code.